Prediction of the Response to a Course of Transcranial Magnetic Stimulation (rTMS) Based on Heart Rate Variability

Inclusion Criteria:

• Having a prescription for a course of rTMS to treat an episod of MDD

• Unipolar MDD confirmed according to DSM-5 criteria

• Moderate to severe MDD (MADRS score > 19)

• No use of psychotropic medication or use stabilised (no change in dose < 4 weeksbefore study entry)

• Able to understand, speak, read and write French

• Express informed consent, after a period of reflection

• Affiliated with a French social security scheme or beneficiary of such a scheme

Exclusion criteria:

• History of epilepsy or convulsive seizures

• Previous brain surgery

• History of recent cranial trauma (< 6 months)

• Presence of severe suicidal ideation

• Psychotic disorders

• Metal objects in the head, eyes or brain

• Implanted ferromagnetic equipment (pace maker, cochlear implant, etc.)

• Clinical evidence of serious or uncontrolled alcohol or substance use disorders inthe three months prior to the study

• Active withdrawal from alcohol or other substances

• One or more recent rTMS sessions (< 4 weeks)

• Other non-drug therapy recently initiated (< 4 weeks) to treat MDD (psychotherapy,phototherapy, vagus nerve stimulation, etc.)

• Prescription of cardiotropic drugs belonging to the following classes: predominantlycardiac calcium channel blockers, Vaughan Williams class I anti-arrhythmics andbeta-blockers.

• Subjects in a period of relative exclusion from another protocol

• Adults protected by law or patients under guardianship or curatorship

• Subjects deprived of their liberty by judicial or administrative decision

• Pregnant or breast-feeding women